Death on the transplant waiting list is an emotive but relevant measure of the ability of a community to care for its members with chronic disease. In this issue, the Liver transplant programme at Royal Prince Alfred Hospital (RPAH) has given us a perspective of the problem that awaits a patient with end-stage liver disease in New South Wales (NSW) today. Both waiting times and mortality on the liver transplant waiting list have risen as the mismatch between the number of donated organs and potential recipients has risen, despite substantial attempts both to maximize donations and to increase the utilization of donated organs. It is worth asking what is needed to reduce this toll?
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